I. Field of the Invention
The present invention relates to evacuation apparatus for removing laser smoke from the operative site during laser surgery. More specifically, the present invention relates to evacuation and suction apparatus for evacuating the gaseous plume of smoke and vapor products of laser surgery as well as liquid material from the operating field.
II. Description of the Prior Art
Laser surgery is becoming an increasingly useful and preferred surgical procedure. For example, laser surgery has been used to remove human tumors and the like. In the laser surgical process, the surgeon applies a highly concentrated beam of coherent light to the surgical site to both cut and cauterize the tissue. The process burns, chars and partially vaporizes the tissue. Laser surgery is preferred to reduce the extent and duration of surgery and to induce better healing of the operative incision. Nonetheless, the burning process of laser surgery is known to generate an offensive and undesirable cloud of particulate laden smoke and vapor referred to as the plume. This plume contains degradation products of tissue charred or burned by exposure to the intensely concentrated energy of the laser beam. The plume generated during laser surgery, if allowed to remain at the operative site, tends to cloud the surgeon's view and to fill the environment of the operating room with plume contaminants. The contaminants may be unsafe and are offensive to the patient and to the physicians, nurses and others attending the surgery.
To accommodate this plume problem, evacuator systems have been developed by which the plume may be withdrawn from the operating field before it escapes into the environment of the operating room. Such an evacuator system typically includes a source of vacuum coupled to a vacuum hose, the nozzle of which is positioned adjacent the operative site to suction the plume away. The evacuator often further includes a series of filters or the like to remove the particulate matter and vapors from the plume as it passes from the vacuum hose into the evacuator unit so that the cleansed air may be exhausted back into the environment of the operating room. An example of such an evacuator is the Lase System II available from U.S. Medical Corporation in Cincinnati, Ohio. The Lase System II was previously available from Lase Inc. in Cincinnati, Ohio. Lase Inc. merged with U.S. Medical Corporation.
While laser plume evacuators are beneficial, such systems are not always sufficient to clear the operative site. In particular, the operative site typically also contains a substantial amount of liquid such as blood or other bodily fluids. Suction of the liquid by the evacuator tends to clog the filters reducing their efficiency and requiring their frequent replacement. Moreover, the evacuator is not equipped to completely and efficiently remove such liquids which may result in fluids accumulating at the operative site.
One proposed solution to the liquid accumulation or removal problem has been to utilize aspirator suction lines conventionally provided at a hospital facility to remove the liquid from the operating room. The built-in hospital aspiration system usually includes a series of suction lines plumbed into the hospital building which may be used during surgery to aspirate the liquid from the operative site. The liquid so removed is to be transported through the fixed plumbing pipes and disposed of at a central location. However, use of a hospital aspiration suction system has serious drawbacks.
The aspirator suction tends to draw off plume as well as liquids. The plume includes tar like components which have a tendency to deposit and accumulate in the plumbing of the hospital aspirator suction lines. Consequently, the aspirator system may eventually foul in which event it may become necessary to tear open the wall of the building to reach the plumbing and replace clogged pipes from time to time.
Where the hospital aspiration system is used to remove both the plume and surgical liquids, the problem is quite aggravated. In this situation, the hospital suction system may clog very rapidly. Further, the suction of the hospital aspiration line is typically not able to draw off all of the plume created during laser surgery. Hence, the operative site may become clouded and/or plume may escape into the operating room environment. Thus, use of an evacuator system along with the hospital aspiration system is the better approach. Even with both the evacuator and hospital aspirator systems, however, clogging is not entirely avoided because the aspiration system tends to draw off some of the plume. Moreover, use of the hospital aspirator to remove primarily liquids, along with the use of an evacuator to remove plume smoke and vapors, is not always an available solution.
For example, laser surgery may be performed in an outpatient clinic or doctor's office environment where built-in aspiration systems are not practical. Portable aspiration systems may be available for this purpose, but they may be subject to clogging as well. In situations where a portable evacuator system and a portable aspiration system are both available, they may require operating room space and separate power sources and thus represent an inconvenience to those attending the surgury. Still further, reuse of portions of a portable aspiration system for subsequent operations presents a sterility management problem.
An even greater drawback to use of a hospital or portable aspiration system is not merely clogging of the system, but that the aspiration system will draw off some amount of plume which will subsequently be discharged, typically untreated, into the environment. Typically, liquid suctioned from the operative site may be collected in a container. To prevent overpressuring of the container, gases which tend to accumulate in the container may be vented to atmosphere. Under these circumstances, plume which enters the aspirator system will often collect in the liquid collection container and then be vented to atmosphere. Thus, some plume would bypass the evacuator filters and the release of some of the obnoxious plume vapors into the air will occur. This is most undesirable, particularly if a portable aspiration unit is employed in the operating room in which event the plume vapors may be released directly back into the operating room.